New Study of Cuts to Texas Family Planning Program Finds Dismaying Early Results

A new report published in the New England Journal Of Medicine, part of a three-year study intended as a direct response to Texas’ drastic family planning cuts in 2011,finds that 53 clinics in the state have closed as a result of a 66 percent reduction in funds championed by conservative lawmakers. But will legislators listen to this new, Texas-focused research that bodes ill for the health and well being of Texans trying to plan their families? Or will they continue to wage a culture war that invigorates a conservative base and decimates programs that do demonstrable good—and that also save money?

Researchers, who interviewed 56 leaders at reproductive health providers and organizations in Texas, characterized the state’s health care network as an “unfortunate situation.” They found that the new policies “are limiting women’s access to a range of preventive reproductive health services and screenings,” creating “circumstances that force clinics and women in Texas to make sacrifices that jeopardize reproductive health and well-being.”

It’s the hope of Dr. Joseph Potter of the Population Research Center at the University of Texas at Austin, who is leading the project, that his Texas-focused research will give legislators the information they need to see just how these policies affect “their most vulnerable constituents.”

“It seems to me that the decisions made in the last session were made without much local information about their likely consequences,” Dr. Potter told RH Reality Check in an e-mail interview. “My hope is that when legislators have more information about what the cuts have meant for their most vulnerable constituents, they might decide to restore lost funding.”

Indeed, discussions around the 2011 cuts centered almost exclusively around Planned Parenthood, and Republican legislators’ professed intent to de-fund the reproductive health care provider at all costs. Never mind the fact that absolutely no public money can be used to fund safe abortion care, according to both federal law and state law.

Legislators claimed that there would be no reduction in access to care as a result of the slashed budget, but an RH Reality Check investigation that I conducted last year in Dallas found those claims to be completely without merit. Not only does Planned Parenthood provide low-cost reproductive health care to many thousands of Texans who would be forced to go elsewhere without Planned Parenthood, but the cuts ensure that the non-Planned Parenthood options, like federally-qualified health centers and other low-cost clinics, would have even fewer resources available to pick up the slack.

My investigation was a precursor to the early results of the University of Texas study, which found: closed clinics, a reduction in services at clinics that have stayed open, and increased costs to low-income patients who already are forced to make hard choices between getting the health care they need and paying rent or feeding their families. From the report:

“Moreover, the impact of these policies is not limited to Planned Parenthood; other organizations have had to close clinics, reduce hours, and lay off dedicated, experienced staff members. We are witnessing the dismantling of a safety net that took decades to build and could not easily be recreated even if funding were restored soon.”

Already, the UT study has found “restricted access to the most effective contraceptive methods” as organizations cope with “higher up-front costs,” opting to provide a $5 pack of pills over, say, a $250 intra-uterine device. According to the report, less effective contraceptive methods that require women to make multiple visits to the doctor or pharmacy have “been shown to result in lower rates of continuation with the method and that may increase the likelihood of unintended pregnancy—and therefore that of abortion.” This, combined with a reduction in overall access and increased prices for patients, does not bode well for Texans. Because the study is ongoing, it remains to be seen what the actual, quantifiable impact of Texas’ budget cuts will be, but according to Dr. Potter, “it seems clear that these changes can only lead to higher rates of unintended pregnancy, and less use of preventive services.”

So many of these findings just make good common sense, and there’s already a bevy of existing research that shows that a reduction in unintended pregnancies results in a lower abortion rate, and that access to contraception results in a lower rate of unintended pregnancies—all of which saves taxpayers money. It bears repeating: for every $1 investment in family planning, taxpayers save $3.74 in Medicaid expenditures.

Preventive care and screenings—such as pap smears—mean healthier people, and the earlier an illness is caught, the less likely a patient is to need invasive or expensive treatment. Reducing access to and funding for these things seems clearly ill-conceived if the point is to save money, promote public health and ensure healthy, wanted pregnancies for women who rely on the ability to plan their families so they can achieve their goals in life.

But, if the point is to pander to a conservative base that continues to spread the lie, for example, that contraception is abortion, all the statistics and studies in the world won’t make a difference. Legislators have to be willing to listen to reason rather than be motivated by the prospect of scoring political points.